The external appearance of the neck may contribute to gender dysphoria, particularly in trans females following pubertal changes. Chondrolaryngoplasty (commonly referred to as “tracheal shave”) reduces the anterior prominence of the thyroid notch to create a flatter neck contour. Traditionally, this procedure has been performed transcervically, but transoral techniques have been recently introduced. Mild and temporary dysphonia and dysphagia are the most common complications after traditional transcervical approach chondrolaryngoplasty; airway adverse events are rare. Changes to voice should be avoided by meticulous intraoperative identification and protection of the anterior attachment of the true vocal folds. Overall, patient satisfaction rates following this safe and effective procedure remain high.